Article

Pes cavus, defined as a high arch in the sagittal plane, occurs in various
clinical situations. A cavus foot may be a variant of normal, a simple
morphological characteristic, seen in healthy individuals. Alternatively, cavus
may occur as a component of a foot deformity. When it is the main abnormality,
direct pes cavus should be distinguished from pes cavovarus. In direct pes cavus,
the deformity occurs only in the sagittal plane (in the forefoot, hindfoot, or
both). Direct pes cavus may be related to a variety of causes, although
neurological diseases predominate in posterior pes cavus. Pes cavovarus is a
three-dimensional deformity characterized by rotation of the calcaneopedal unit
(the foot minus the talus). This deformity is caused by palsy of the intrinsic
foot muscles, usually related to Charcot-Marie-Tooth disease. The risk of
progression during childhood can be eliminated by appropriate conservative
treatment (orthosis to realign the foot). Extra-articular surgery is indicated
when the response to orthotic treatment is inadequate. Muscle transfers have not
been proven effective. Triple arthrodesis (talocalcanear, talonavicular, and
calcaneocuboid) accelerates the mid-term development of osteoarthritis in the
adjacent joints and should be avoided.
CI - Copyright (c) 2012. Published by Elsevier Masson SAS.

Langue : FRANCAIS